Multiple perineal sinuses in non-hodgkin's lymphoma

Area of Science:

• Oncology
• Dermatology
• Pathology

Background:

• Chronic perineal sinuses and inguinal lymphadenopathy can present complex diagnostic challenges.
• Non-Hodgkin's lymphoma (NHL) can manifest with secondary cutaneous involvement, including dermatoses.

Purpose of the Study:

• To report a rare case of primary nodal NHL presenting with secondary cutaneous manifestations as chronic perineal sinuses.
• To highlight the diagnostic approach and successful management of this condition.

Main Methods:

• Clinical presentation of a 60-year-old male with a decade-long history of perineal sinuses and lymphadenopathy.
• Histopathological examination of inguinal lymph node and sinus biopsies.
• Diagnosis of primary nodal follicular B-cell non-Hodgkin's lymphoma with paraneoplastic dermatosis.
• Treatment with two courses of chemotherapy.

Main Results:

• Inguinal lymph node biopsy confirmed follicular B-cell non-Hodgkin's lymphoma.
• Sinus biopsies were non-specific.
• Following chemotherapy, the perineal sinus discharge ceased, and lesions healed with scarring.

Conclusions:

• Chronic perineal sinuses can be an unusual cutaneous manifestation of underlying non-Hodgkin's lymphoma.
• Early diagnosis and appropriate chemotherapy can effectively manage paraneoplastic dermatoses associated with NHL.
• This case underscores the importance of considering systemic malignancy in patients with chronic, unexplained skin lesions.